Individual provider Active NPI

Pratik S Patel, DMD

  • Dentist
  • Sunrise, FL
National Provider Identifier
1922591619
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23440 Issued in FL
Practice address
1350 SW 160TH Ave
Sunrise, FL 33326-1908
Phone
(954) 385-9240
Fax
(954) 385-9260
NPI assigned
Jun 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23440 FL Primary

Addresses

Primary practice location

1350 SW 160TH Ave
Sunrise, FL 33326-1908

Mailing address

11808 NW 2ND St
Coral Springs, FL 33071-8020
Phone (732) 910-7949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN23440FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Swan Dental Corp Dentist CurrentSince Sep 23, 2021 Accepting new patients
Nexgen Dental LLC Dentist CurrentSince Jan 19, 2020 Accepting new patients
Syd Associates, PA PastSince Jul 1, 2020 Accepting new patients
Weston Family Dental Center, Inc Dentist PastSince Sep 23, 2021 Accepting new patients
Professional Dental Alliance of Florida, PLLC PastSince Jul 1, 2020 Accepting new patients

Locations

1350 SW 160th Ave
Sunrise, FL 33326
Phone (954) 385-9240

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1922591619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 NW 2ND ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718020",
            "telephone_number": "732-910-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SW 160TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261908",
            "telephone_number": "954-385-9240",
            "fax_number": "954-385-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRATIK",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.